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My WC ordeal

AnonymousUserAAnonymousUser Posts: 49,899
edited 06/11/2012 - 8:22 AM in Health Insurance Issues
I will try to be breif... I am covered under Indiana WC. My injuries are Inpingment of my shoulder and Myofascial Pain that is spreading to by back, arms, legs, neck and I have a constant headach.
This all started 6 months ago. I got hurt on the job. It took over 5 weeks for the WC Ins. Carrier to accept my claim. They sent me to "Their" doctor. I saw him for about 2 mths, while seeing him I was in PT for the first month then PT and Deep tissue message for the second month. He then released me temporaraly for 2 weeks (NOT MMI) but so we could see how bad my shoulder got. When I was to go back to work my company FIRED ME without letting me return to work. I was getting worse day by day so I returned to the Doctor. When I saw him he refered me to a shoulder specialist/suregon and a chiropractor. This is where the trouble started..
The WC Ins. Carrier informed me that they were NOT going to pay me and they wanted a second opinion. 9 weeks and STILL no second opinion. They FINALLY sent me a Termination of benifits letter 2 1/2 weeks later than allowed by State Board. I used the Termination papers to file for an IME. My IME was set for 6 weeks out. The WC Ins. Carrier was informed by the Indiana Board to send me TTD for 14 days and to pay for my travel in advance. That was 2 1/2 weeks ago. We have had NO income for 8-9 weeks and we are about to lose EVERYTHING. I can't even get my kids shoes or all of their school supplies. Somehow this Ins. carrier can "do no wrong" and isn't held accountable for anything they have OR haven't done. All of this while I sit at home with NO treatment or help for my conditions that are getting worse. I can't sleep, I am having Anxiety problems and I'm depressed. Everything I have worked for is going down the drain and no one can or will stop it!
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Comments

  • You need to have a lawyer...
  • j.howiejj.howie Brentwood, Ca., USAPosts: 1,728
    I live in california, And the work comp. laws are surely different, but I would get a lawyer before you loose everything you've worked for.
    Good luck Jim
    Click my name to see my Medical history
    You get what you get, not what you deserve......I stole that from Susan (rip)
    Today is yours to embrace........ for tomorrow, who knows what might be starring you in the face!
  • I have one now, but they don't seem to be getting anywhere. All I get is " sorry I called their layer and didn't get an answer" So I guess i'm going to have to wait it out and hope they pay as soon as my IME is done. That will be a good chunk of back pay but may be too late for some stuff, let alone me just sitting here getting worse. Nobody seems to care about that.
  • Oh dear hun, Im so sorry to hear about all thet cr@p. One thing that makes me glad to live in Australia. I hope your lawyer helps you sort things out.
  • Hello, My wife got hurt on the job. She was recieving wc benefits and her doctor released her back to work to light duty. He also said she needs a second opinion. Her job doesnt have any light duty so the wc insurance company stopped paying her. Her lawyer said to apply for unemployment in the meantime so you wont loose much pay. Sorry to here about your work problems but insurance cos. are mean and nasty. I would make sure your lawyer is agressive not all are. Keep a folder of all your dr visits and therapy visits also drs addresses and phone numbers, days of your appointments and problems you had on those given dates. Try to make an appointment to see the original dr and tell him how you feel, including depression and pain. I know what you are going thru I am also on wc. It is not an easy route. You still have your family and they need you. Good luck to you......Hoot
  • Thanks for the replies. And thanks for any future replies.
  • If your attorney is not getting anywhere and giving you the run around they need to send a over night certified letter to the defense attorney. Don't let them give you the run around there is always away to get a hold of them. Go on to your state's website and make yourself very familiar with the laws of you state. There should be a emergency appeal process that you can use. Also definitely apply for unemployment. Another thing you can do is contact your local church and if it is a rather large church usually will have attorney's that will do some pro bono work as well as away to ease up some of you financial issues in the short term. I have one question are they sure you injury is not neck related vs a shoulder injury. Good luck and i hope things work out.
  • Dr. actually said "They should have never stopped your care" and said that he will have a report written in a day or so and the WC Board will have it in a week. Then the WC Board will demand they send me my 8 weeks back pay and they will have to go back to paying me EVERY week.

    Care wise they will send me to a doctor and they will give me (my shoulder) one more chance with a shot and therapy. AGAIN, some more. If that doesn't work I will have surgery to remove scar tissue and to grind down my bone to help with the Impingement. They say if they fix my shoulder my Myofascial Trigger Points will go away by themselves???
  • Hmmm, my state is completely different, and I think you should check this out. My attorney tells me that even though I have been released back to work part time, WC has to keep paying me until I find a comparable job. (Not that my neck will let me work at a desk any longer, :''( i'm going to have to change careers). I'm a little surprised that your lawyer told you to file for unemployment rather than him pushing the WC insurance carrier to keep your benefits coming. that does not sound right to me. If you were at MMI, it would be a different story, but since you are not, you are entitled to the TTD benefits until you find another job, at least that is how I understand it.

    I agree with tamtam. Go online and research your state worker compensation laws.

    I also agree with tamtam when she questions if it could be coming from your neck. Have you had a c-spine MRI? My symptoms were initially just arm/shoulder pain and I was completely shocked (almost didn't believe it) when I was diagnosed with neck problems. In time though there was no doubt because every movement of the neck increased the pain in the arm and shoulder. I think you should see a spine specialist (not a chiropractor) just to make sure they are treating you for the correct problem. The first doctor I saw told me it was just tight muscles and I needed to see a chiro. 2nd doc told me it was thoracic outlet syndrome. Finally had an MRI which confirmed that it was neck, not either of the first 2 diagnoses. How did you injure yourself at work? Please be insistent that you get the care you deserve. It is concerning to me that you are having issues with your legs and they are labeling this shoulder related. I don't think that is anatomically possible, but then again, I'm not a doctor.
    Surviving chronic pain one day at a time, praying for a reprieve because living another 40 years like this doesn't sound too fun!
  • My husband was not taken back to work when he was relased either he was told to apply for unemployment and he got it because he could work and they wouldn't take him back. The only kick is that when we do settle the WC case that money will have to be paid back. We didn't care because we needed the money right away. We went 11 months exactly before our atty got WC to pay TTD. My husband has been on this for 2 years now and we still have not settled his case.

    Our atty really didn't seem to be doing anything either for a while and then he expalined to us that there is little he can do until the case comes up to settle. He just keeps sending paperwork to the insurance company and then we wait. What they told us is make sure you keep a detailed record of everything because eventually you can prove that the insurance company was working in bad faith and can get fined up to 20K. (at least in WI).

    Don't give up this is a terrible battle. The only way I found peace in this is to start writing a book on the abuse and corruption of the WC system. If you want to share your story with me or have anyone that can help expose this corrupt system let me know.

    Deb
  • Hi all, am new here, just surfing and checking how much would a disectomy cost and got the answer from one of the forums. I was on wc, did all the paper work and opted for the continued medical care instead of the lump sum. Now that I quit my job, claims adjustor, wanted to close my case and offered me US$10,000. I was in shock bec. this will not be enough for the surgeons fee if I opt for an operation. I have hurt my back L3-S1 while at work (CA), never used an attorney. But now that the adjustor wants to close my case, I'm gonna look for one. I read from somewhere, once your case is closed, it will never be opened again.
    If anyone had the same experience, I'd greatly appreciate it.
    honeybee
  • honeybee said:
    Hi all, am new here, just surfing and checking how much would a disectomy cost and got the answer from one of the forums. I was on wc, did all the paper work and opted for the continued medical care instead of the lump sum. Now that I quit my job, claims adjustor, wanted to close my case and offered me US$10,000. I was in shock bec. this will not be enough for the surgeons fee if I opt for an operation. I have hurt my back L3-S1 while at work (CA), never used an attorney. But now that the adjustor wants to close my case, I'm gonna look for one. I read from somewhere, once your case is closed, it will never be opened again.
    If anyone had the same experience, I'd greatly appreciate it.
    honeybee
    You are doing a smart thing,get a lawyer and let them help you,dont let wc sell you out....
  • Yeah, getting an atty at this point in time would be a good idea...
  • kingskippy2001 said:
    Dr. actually said "They should have never stopped your care" and said that he will have a report written in a day or so and the WC Board will have it in a week. Then the WC Board will demand they send me my 8 weeks back pay and they will have to go back to paying me EVERY week.

    Care wise they will send me to a doctor and they will give me (my shoulder) one more chance with a shot and therapy. AGAIN, some more. If that doesn't work I will have surgery to remove scar tissue and to grind down my bone to help with the Impingement. They say if they fix my shoulder my Myofascial Trigger Points will go away by themselves???
    HERE IS AN UPDATE!!!!

    The WC found me a new Doctor. He seems to know his stuff he has worked on some VERY high profile athletes. I do like him. I saw him for the first time around Thanks giving. At my first visit he told me " You have had to many shots and they won't do anything now if they didn't before". Then he sent a letter for approval for surgery.

    They (WC) informed him that he HAD to give me another shot or they would go find as DR. that would (my 5th shot in 8 months) and I had do do physical therapy. SO we did it. It helped for about 25% of the pain and movement due to swelling FOR 1 1/2 WEEKS!

    I went back around before Christmas and the Dr. came in my room and laughed and said "All better, right?" So he wrote the WC ins. carrier and asked again for approval for surgery. This makes the 2nd Doctor and the 3rd time that a Doctor has wanted me to have surgery.

    They FINALLY approved me for surgery. I go back on JAN. 7th, for testing and to discuss the surgery and the physical therapy afterwards. So, I might finally see some light at the end of the tunnel.

    I can't go into details but, I do have a VERY GOOD lawyer. He is considered the best in the state of Indiana for Work Comp. They have treated me good since becoming a client. Now there is talk of "intentional" delays. So they Work Comp. Ins carrier may have to "make it right" for delaying me for 5-7 months. I could have had my surgery and been back to work 2-5 months ago.
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